Smjernice za neinvazivnu mehaničku ventilaciju pri liječenju kronične respiracijske insuficijencije [Guidelines for noninvasive mechanical ventilation for treatment of chronic respiratory failure]

The use of noninvasive ventilation (NIV) has been markedly increased over the past two decades, as an effective method of managing acute and chronic respiratory failure. Patients suffering from chronic respiratory failure can be introduced to home NIV. The most frequent diseases leading to chronic respiratory failure are chronic obstructive pulmonary disease (COPD), obesity hypoventilation syndrome (OHS), restrictive thoracic diseases and neuromuscular diseases (NMD). NIV application improves blood gases, symptoms, quality of life and prolongs survival of these patients. Nowadays, noninvasive ventilation is mostly performed by positive pressure ventilators and bilevel positive airway pressure (BiPAP) is the most common mode used. The choice of appropriate interface is the key to successful application of noninvasive ventilation. Home NIV must be introduced through specialized centers. The physicians are responsible for indicating home NIV, choosing the type of ventilator, the ventilation mode and ventilation parameters. The objective of this document is to provide clinicians with information on technical aspects of home NIV, to establish diagnostic and therapeutic strategies for initiating home NIV, indications, contraindications and recommended settings for each group of diseases.